National Provider Identifier [NPI]: |
1730174665 |
Last Name Of The Provider |
COPELAND |
First Name Of The Provider |
ROBERT |
Middle Initial Of The Provider |
B |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
1551 DOCTORS DRIVE |
Street Address 2 Of The Provider |
BUILDING 200 |
City Of The Provider |
LAGRANGE |
Zip Code Of The Provider |
302404139 |
State Code Of The Provider |
GA |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Cardiology |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
17 |
Number Of Services |
1876 |
Number Of Medicare Beneficiaries |
1143 |
Total Submitted Charge Amount |
112557 |
Total Medicare Allowed Amount |
41533.44 |
Total Medicare Payment Amount |
29502.42 |
Total Medicare Standardized Payment Amount |
30798.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
17 |
Number Of Medical Services |
1876 |
Number Of Medicare Beneficiaries With Medical Services |
1143 |
Total Medical Submitted Charge Amount |
112557 |
Total Medical Medicare Allowed Amount |
41533.44 |
Total Medical Medicare Payment Amount |
29502.42 |
Total Medical Medicare Standardized Payment Amount |
30798.4 |
Average Age Of Beneficiaries |
72 |
Number Of Beneficiaries Age Less65 |
257 |
Number Of Beneficiaries Age 65 to 74 |
384 |
Number Of Beneficiaries Age 75 to 84 |
329 |
Number Of Beneficiaries Age Greater 84 |
173 |
Number Of Female Beneficiaries |
595 |
Number Of Male Beneficiaries |
548 |
Number Of Non Hispanic White Beneficiaries |
855 |
Number Of Black or African American Beneficiaries |
261 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
13 |
Number Of Beneficiaries With Medicare Only Entitlement |
759 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
384 |
Percent Of With Atrial Fibrillation |
26 |
Percent Of With Alzheimers Disease or Dementia |
17 |
Percent Of With Asthma |
10 |
Percent Of With Cancer |
13 |
Percent Of With Heart Failure |
44 |
Percent Of With Chronic Kidney Disease |
43 |
Percent Of With Chronic Obstructive Pulmonary Disease |
30 |
Percent Of With Depression |
25 |
Percent Of With Diabetes |
49 |
Percent Of With Hyperlipidemia |
67 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
62 |
Percent Of With Osteoporosis |
7 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
42 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
8 |
Average HCC Risk Score Of Beneficiaries |
1.8856 |